Despite the success of treating dentofacial deformities using orthodontics and surgery, some types of deformities still cannot be corrected with predictable results, long-term stability, and patient satisfaction. The goals of this proposal are to delineate the risk factors associated with long term instability after treatment, and to clarify the ultimate outcomes of the treatment of dentofacial deformity, using and enlarging the extensive University of North Carolina database. Data on the long-term skeletal and dental changes and the patients evaluation of these changes will be examined for three purposes: (1) to more clearly differentiate the patient-perceived and objective outcomes of orthognathic surgery vs. Orthodontics alone in the treatment of dentofacial deformity; (2) to place both short- and long-term risks of both types of treatment in perspective so that patients can make more informed choices between alternative approaches; and (3) to clarify the circumstances in orthognathic surgery that allow outpatient (day-op) care as opposed to inpatient hospitalization by evaluating both the objective and patient perceived experience and adverse events that occur in each of these settings.